Collection and Analysis of Vital Signs

ABSTRACT

A system is disclosed having a storage, a communications module for interacting with a medical measurement device, an analysis controller, and a test module that allows for the testing and evaluating of decision-support algorithms. A method for testing decision-support algorithms is disclosed having the steps of receiving into storage of a ruggedized, compact computer at least one decision-support algorithm; detecting with a communications module the initiation of a vital-sign monitoring session; receiving and storing vital-sign information into storage by the communications module; pushing the stored vital-sign information by an analysis controller to a test module running the stored at least one decision-support algorithm; and providing at least one output from the decision-support algorithm to at least one of a database and a display.

This application claims the benefit of U.S. provisional patentapplication No. 61/401,179 filed Aug. 6, 2010 and entitled “System forReal-Time Collection and Analysis of Vital Signs and Prediction ofClinical Outcomes,” which is hereby incorporated by reference.

I. FIELD OF THE INVENTION

This invention relates to a system and method for developing, testing,and evaluating decision-support algorithms in a portable unit usingstored data and/or real-life, real time data.

II. BACKGROUND OF THE INVENTION

Typically, decision-support algorithms are incorporated into vital-signmonitors and other medical recording systems. This results in thealgorithms being proprietary to the manufacturer and not facilitatingeasy modification or refinement by end-users and/or testing of newdecision-support algorithms by either the manufacturer or the end-users.

Most of the existing literature discusses research in thedecision-support area that uses retrospective analysis of previouslygathered data to test and refine decision-support systems located onworkstations and/or servers.

III. SUMMARY OF THE INVENTION

The invention provides in at least one embodiment a system for receivingan output from an external source where the system includes: a storage;a communications module for receiving vital-sign data from an externalsource and storing the received data in said storage; an analysiscontroller in communication with said storage, said analysis controllermonitors said storage; and a test module in communication with saidanalysis controller and said storage, said test module receivesinformation from said storage through said analysis controller andstores any output in said storage, and said test module includes runningmeans for running at least one algorithm loaded into said storage wheresaid at least one algorithm processes at least a portion of theinformation provided by said analysis controller.

The invention provides in at least one embodiment a system for receivingvital-sign information from a vital-sign monitor, said system including:a storage having at least one database; a communications module forreceiving vital-sign data from an external source and storing thereceived data in said database of said storage; an analysis controllerin communication with said storage, said analysis controller monitorssaid storage; a test module in communication with said analysiscontroller and said storage, said test module receives information fromsaid storage through said analysis controller, and said test moduleincludes running means for running at least one algorithm loaded intosaid storage where said at least one algorithm processes at least aportion of the information provided by said analysis controller, saidrunning means provides an output in substantially real time from receiptof vital-sign data by said communications module; a ruggedized, compacthousing enclosing said storage, said communications module, saidanalysis controller, and said test module.

The invention provides in at least one embodiment a method for testingdecision-support algorithms where the method includes: receiving intostorage of a ruggedized, compact computer at least one decision-supportalgorithm; detecting with a communications module the initiation of avital-sign monitoring session; receiving and storing vital-signinformation into storage by the communications module; pushing thestored vital-sign information by an analysis controller to a test modulerunning the stored at least one decision-support algorithm; andproviding at least one output from the decision-support algorithm to atleast one of a database and a display.

Given the following enabling description of the drawings, the inventionshould become evident to a person of ordinary skill in the art.

IV. BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is described with reference to the accompanyingdrawings. In the drawings, like reference numbers indicate identical orfunctionally similar elements. The use of shading within the drawings isnot intended as limiting the type of materials that may be used tomanufacture the invention.

FIG. 1 illustrates a block diagram including a data flow according to anembodiment of the invention.

FIG. 2 illustrates a block diagram according to an embodiment of theinvention.

FIG. 3 illustrates an embodiment according to the invention.

FIG. 4 illustrates a flowchart of a method embodiment according to theinvention.

FIG. 5 illustrates a computer program product and computerimplementation according to an embodiment of the invention.

V. DETAILED DESCRIPTION OF THE DRAWINGS

FIGS. 1-4 illustrate different embodiments and aspects according to theinvention.

In at least one embodiment, the system 100 is compact, which for thisdisclosure is defined as being easily moved and transported, forexample, between a vehicle such as an ambulance or helicopter to amedical facility with the patient. Compact is further defined as smallerthan a laptop and small relative to a vital-sign monitor 190 such asillustrated, for example, in FIG. 3. Compact is further defined by beingof sufficiently small size to allow for use in the field away fromestablished medical facilities.

In at least one embodiment, the system is ruggedized, which for thisdisclosure is defined as being able to substantially withstandvibration, shock, temperature, temperature shock, altitude, dropping,rain, dust, and humidity and remain substantially working andoperational for its intended purpose.

In at least one embodiment, the system operates in real time, which forthis disclosure is defined as storing and processing a continuous streamof vital-sign information (or data) as outputted by a vital-sign monitorwhere the processing includes any algorithm 1254 present in the testmodule 125 with substantially minimal lag time (e.g., allows forprocessing time by the algorithm(s) 1254).

As illustrated in FIG. 1, the flow of data through at least oneembodiment includes a system 100 having a communications module 110, astorage 115, an analysis controller 120, and a test module 125. Thecommunications module 110 is in communication with the storage 115. Theanalysis controller 120 is in communication with the storage 115 and thetest module 125, which in at least one embodiment is in communicationwith the storage 115. As used in this disclosure “in communication”includes physical and wireless connections that are indirect through oneor more additional components (or over a network) or directly betweenthe two components described as being in communication.

FIG. 1 also illustrates an example of how data will flow through atleast one embodiment. The output of the vital-sign monitor (or othermedical monitor or external source) 190 is received by thecommunications module 110 that stores the received data into storage (ormemory) 115. In at least one embodiment, storage 115 includes a databasefor storing the received data. For the purposes of this disclosure, adatabase includes any type of list, data table, relational database, atext file, a comma delimited file, data log file, or a series of datafiles associated with one session. The analysis controller 120 monitorsthe storage 115 for the addition of new data that it will push to thetest module 125. The test module 125 provides an environment in which aloaded algorithm(s) 1254 operates to produce a result based on at leasta portion of the data pushed by the analysis controller 120. Theproduced result in at least one embodiment is provided to at least oneof the storage 115 including, for example, the database used for thereceived data or a separate database; a display 130; or for transmissionto an external device through, for example, a wired connection or anantenna 1054.

FIG. 2 illustrates an embodiment similar to that of FIG. 1 without theflow of data being represented. FIG. 2 illustrates the system asincluding a communications module 110, a storage 115, an analysiscontroller 120, and test module 125.

The communications module 110 maintains the connection with thevital-sign monitor 190 and stores the received data (e.g., vital-signinformation) into storage 115. The communications module 110 in at leastone embodiment transmits a “keep-alive” (or similar) packet (or message)to the vital-sign monitor 190 to maintain the connection and avoidtermination of the connection by the vital-sign monitor 190. Thecommunications module 110 in at least one embodiment traps errors andrecovers from communication errors using, for example, cyclic redundancycheck to determine if corruption is present in the received packet ofinformation. In addition in further embodiments, the communicationsmodule 110 uses a sequential packet number, which in at least oneembodiment cycles through a set of numbers, present at the start of eachpacket to maintain the received packets in order prior to storage 115 ofthe received information, which is useful in a network environment withmultiple paths between the vital-sign monitor and the communicationsmodule. For example, the Welch Allyn Propaq vital-sign monitors producepackets at different frequencies. Numerical data from the vital-signmonitor, such as heart rate, respiratory rate, blood oxygen saturation,and noninvasive systolic, diastolic, and mean blood pressures, areoutputted at a frequency of 1 Hz (once per second). Theelectrocardiogram (ECG), photoplethysmogram (PPG), and impedancepneumogram (IP) are waveforms that are reported at 182 Hz, 91 Hz, and 23Hz, respectively, and in at least one embodiment the packets are sentevery 88 ms with each packet having 16, 8, and 2 data points,respectively. The communications module 110 stores these data packets asthese packets are received and, if necessary, the communications module110 arranges them in order prior to storing in the storage 115.

In at least one embodiment, the communications module 110 is in astandby state until it receives a numeric heart rate value greater than10 beats per minute or between 10 and 350 beats per minute and ends asession when no such value is received for a 5-minute interval (althoughother time periods may be used), for example, any length of time in arange of 2 to 15 minutes (including the end points). The end of thesession in at least one embodiment is based on a predetermined thresholdof length of time (predetermined time threshold) of receipt values lessthan 10 beats per minute (predetermined vital-sign threshold). Therequirement for a heart rate value indicative of life provides areasonable basis to assume that the vital-sign monitor 190 is attachedto a person. However, in alternative embodiments, another vital-signsuch as SpO₂ is used to determine whether a patient is connected to thevital-sign monitor. In a further embodiment, a signal representing thata patient is connected or other status indication such as a “fault”state from ECG leads being cleared is provided by the vital-sign monitor190 to the communications module 110 to indicate when a session hasstarted and/or ended. The end condition reflects the case where thevital-sign monitor 190 is turned off or simply detached from the patientat the end of a medical session such as arrival at a medical facility.It is estimated that a one-hour session will require approximately 5 MBof disk space. In this embodiment, once the communications module 110detects the start of a session, then it notifies and/or activates theanalysis controller 120 and/or the test module 125 to start.

In a further embodiment, the communications module 110 timestamps thevital-sign information as part of the storing the information intostorage 115. The timestamp allows for improved archival of theinformation and for review of the information outputted by the testmodule 125, which in at least one embodiment allows for furtherrefinement of the algorithm(s) 1254 operating in the test module 125.

The storage 115 in at least one embodiment is computer storage 115medium as defined later in this disclosure. An illustrative example ofthe storage 115 is a memory. Based on this disclosure, it should beappreciated that storage 115 also includes a plurality of discretestorages for the different data being stored in the system.

The analysis controller 120 monitors the physiological data logged intothe storage 115 for the presence of new data in at least one embodiment.When new data are detected and/or a new session started, the analysiscontroller 120 pushes that data to the test module 125 by extracting theinformation from storage 115 and providing it in an appropriate syntaxfor use by the algorithm(s) 1254 operating in the test module 125.

In at least one embodiment, the analysis controller 120 converts thepacket data into multiple constant-frequency row vectors. The vector inat least one embodiment has a length equal to the frequency multipliedby the time period (e.g., the example below has a vector length of 4).The analysis controller 120 aligns and/or shifts the data contained inthe storage 115 to take into account any communication breaks and/ormissing data. For example if the storage 115 contains the following datawhere Seq represents the packet number (or sequence):

Time=0, Seq=100, Data=[HR: 80, SaO₂: 98] Time=1, Seq=101, Data=[HR: 82]Time=3, Seq=103, Data=[HR: 81, SaO₂: 97]

The analysis controller 120 converts the information into two vectors(one for heart rate (HR) and one for oxygen saturation (SaO₂)):

HR=[80 82 NaN 81] SaO₂=[98 NaN NaN 97]

where NaN (Not a Number) is representative of missing data, which inthis example Sequence 101 was missing SaO₂ and Sequence 102 was missingin its entirety (or lost). The missing data was filled in with NaNs(although other fillers could be used to indicate the missing data) topreserve a frequency of 1 Hz for the data.

In an example where the sampling by the analysis controller 120 is tooccur at 5 seconds, but the packet (Sequence 104) has not been stored inthe storage 115. The analysis controller 120 in at least one embodimentincludes a time threshold beyond which it will consider the packet to belost.

In at least one embodiment, the analysis controller 120 pushes the databased on a predetermined sampling period to reduce the load on the testmodule 125 based on the algorithms being run in the test module 125. Forexample, in at least one embodiment, the analysis controller 120retrieves the current data every 5 seconds although the algorithm(s)1254 running in the test module 125 uses data at approximately 2 minuteintervals. In at least one embodiment, the analysis controller 120 isimplemented on a processor as a configurable shell.

The test module 125 hosts and runs at least one algorithm with examplesof the algorithms including but not limited to the following functions:pattern recognition, generation of graphical displays, generation oftext files, determination of data quality, prediction of patient outcomeusing for example artificial intelligence classifiers, analysis oftime-series vital-sign data, etc. In at least one embodiment, the testmodule 125 includes running means 1252 for running the algorithm(s) 1254such as a software environment running on a processor in which the codeused to write the algorithm(s) is capable of functioning and interactingwith the vital-sign information provided to it by the test module 125.The test module 125 retrieves at least one algorithm 1254 from storage115 and runs it in response to data received from the analysiscontroller 120. In at least one embodiment, the analysis controller 120and/or test module 125 restrict the frequency of data provided to thealgorithm(s) 1254 to reflect the processing time required for thealgorithm(s) 1254, which results in data being provided at predeterminedtime intervals with some data being ignored with the most recent valuesbeing used at the predetermined time intervals. By retrieving thealgorithm(s) 1254 from storage 115, it allows for the algorithm(s) 1254to be updated, modified, or changed by loading into the storage 115 thenew/modified algorithm making it available for the next session.

The result produced by the algorithm(s) 1254 is provided by the testmodule 125 to at least one of the storage 115, the display 130, and anexternal device (not shown). In at least one embodiment, there are atleast two algorithms running with the first algorithm reviewing thevital-sign information for quality control and providing a filteredoutput of the vital signs that pass quality control to the second ormore algorithms running in the test module 125.

In at least one embodiment, the data placed into storage 115 isorganized by session, which as used in this disclosure means a timeperiod from when a patient is connected to a vital-sign monitor to thetime that they are disconnected for a period longer than thepredetermined time threshold discussed above from the vital-signmonitor.

The algorithms 1254 that are tested, evaluated and/or used in theabove-described embodiments will need to use the data syntax used by theanalysis controller 120. In at least one embodiment, the algorithm(s)1254 will have as its respective input(s) at least a portion of thevital signs in a form that will be able to communicate with the analysiscontroller 120. In at least one embodiment, the test module 125 willdiscard vital signs not of interest to the algorithm(s) 1254; however,in other embodiments the test module 125 provides all vital signsreceived from the analysis controller 120 to the algorithm(s) 1254 withthe algorithm(s) 1254 deciding what data it wants to use. In at leastone embodiment, the test module 125 and the algorithm(s) 1254 are builtusing the same computer language or code such as MATLAB, C, or LabVIEW.

FIG. 3 illustrates an example of an embodiment built according to theinvention attached to a vital-sign monitor 190 such as the Propaq Encoresold by Welch Allyn although other vital-sign monitors could be usedinstead. There are a variety of ways for the system to communicate witha vital-sign monitor including but not limited to wireless or wired,such as a RS-232/USB cable adaptor or RS-232/serial cable adaptor 192.Based on this disclosure, it should be appreciated that there are avariety of additional ways that a vital-sign monitor 190 can beconnected to the system besides the illustrated connector. FIG. 3 alsoillustrates an embodiment of the system including a display 130 and ahousing 105 with a connector 1052. The illustrated system 100 was builtwith a test module 125 using MATLAB.

FIG. 4 illustrates a flowchart of a method embodiment according to theinvention for using the system illustrated in FIG. 2. The illustratedmethod in at least one embodiment is for operation of a compact computeror a ruggedized, compact computer. In at least one embodiment prior toinitiation of a session, the computer receives at least one algorithminto storage 115, 405. The algorithm(s) 1254 will be used by the testmodule 125 during a session. In at least one embodiment, the methodincludes detecting with the communications module 110 the initiation ofa vital-sign monitoring session, 410. The communications module 110receives and stores the vital-sign information into storage 115, 415. Asdiscussed above in at least one embodiment, the analysis controller 120retrieves the vital-sign information from storage 115 and pushes thevital-sign information to the test module 125 running the stored atleast one decision-support algorithm 1254, 420. The test module 125provides at least one output from the decision-support algorithm 1254 toat least one of a database 115 and a display 130, 425, or in analternative embodiment to an external device by for example wirelesstransmission through an antenna 1054 of the output. In a furtherembodiment, the test module 125 outputs an audible alert when thealgorithm(s) 1254 detects a critical condition or other predeterminedsituation. In a still further embodiment, the test module 125 retrievesthe stored decision-support algorithm(s) 1254 from storage 115 after asession is initiated; or alternatively, the decision-supportalgorithm(s) 1254 is available in the test module 125 once received instorage 115.

In at least one embodiment, after multiple sessions are stored by thesystem, the stored data are transferred from the system for analysis andevaluation to determine whether the stored algorithm has functioned asintended and/or whether improvements should be made to the storedalgorithm.

In at least one embodiment, the information captured by the system isstored or copied to a computer storage medium capable of removable formthe system for transfer to the medical facility where the patient hasbeen taken. Alternatively, this information is transmitted wirelessly tothe medical facility.

As will be appreciated by one skilled in the art based on thisdisclosure, aspects of the present invention may be embodied as asystem, method or computer program product. Accordingly, aspects of thepresent invention may take the form of an entirely hardware embodiment,a processor operating with a software embodiment (including firmware,resident software, micro-code, etc.) or an embodiment combining softwareand hardware aspects that may all generally be referred to herein as a“circuit,” “module” or “system.” Furthermore, aspects of the presentinvention may take the form of a computer program product embodied inone or more computer readable medium(s) having computer readable programcode embodied thereon.

Any combination of one or more computer readable medium(s) may beutilized. The computer readable medium may be a computer readablestorage medium. A computer readable storage medium may be, for example,but not limited to, an electronic, magnetic, optical, electromagnetic,infrared, or semiconductor system, apparatus, or device, or any suitablecombination of the foregoing. More specific examples (a non-exhaustivelist) of the computer readable storage medium would include thefollowing: an electrical connection having one or more wires, a portablecomputer diskette, a hard disk, a random access memory (RAM), aread-only memory (ROM), an erasable programmable read-only memory (EPROMor Flash memory), an optical fiber, a portable compact disc read-onlymemory (CD-ROM), an optical storage device, a magnetic storage device,or any suitable combination of the foregoing. In the context of thisdisclosure, a computer readable storage medium may be any tangiblemedium that can contain, or store, a program for use by or in connectionwith an instruction execution system, apparatus, or device. The aboveexamples of computer readable storage medium are also examples of thestorage of the above discussed embodiments.

Computer program code for carrying out operations for aspects of thepresent invention may be written in any combination of one or moreprogramming languages, including an object oriented programming languagesuch as Java, Smalltalk, C++, C#, or the like and conventionalprocedural programming languages, such as the “C” programming languageor similar programming languages. The program code in at least oneembodiment executes entirely on the compact, portable computer as astand-alone software package.

The flowchart and block diagrams in the Figures illustrate thearchitecture, functionality, and operation of possible implementationsof systems, methods and computer program products according to variousembodiments of the present invention. In this regard, each block in theflowchart or block diagrams may represent a module, segment, or portionof code, which comprises one or more executable instructions forimplementing the specified logical function(s). It should also be notedthat, in some alternative implementations, the functions noted in theblock may occur out of the order noted in the figures. For example, twoblocks shown in succession may, in fact, be executed substantiallyconcurrently, or the blocks may sometimes be executed in the reverseorder, depending upon the functionality involved. It will also be notedthat each block of the block diagrams and/or flowchart illustration, andcombinations or subcombinations of blocks in the block diagrams and/orflowchart illustration, can be implemented by special purposehardware-based systems that perform the specified functions or acts, orcombinations of special purpose hardware and computer instructions.These computer program instructions may be provided to a processor of ageneral purpose computer, special purpose computer, or otherprogrammable data processing apparatus to produce a machine, such thatthe instructions, which execute with the processor of the computer orother programmable data processing apparatus, create means forimplementing the functions/acts specified in the flowchart and/or blockdiagram block or blocks.

These computer program instructions may also be stored in a computerreadable medium that can direct a computer, other programmable dataprocessing apparatus, or other devices to function in a particularmanner, such that the instructions stored in the computer readablemedium produce an article of manufacture, including instructions whichimplement the function/act specified in the flowchart and/or blockdiagram block or blocks.

The computer program instructions may also be loaded onto a computer,other programmable data processing apparatus, or other devices to causea series of operational steps to be performed on the computer, otherprogrammable apparatus or other devices to produce a computerimplemented process such that the instructions which execute on thecomputer or other programmable apparatus provide processes forimplementing the functions/acts specified in the flowchart and/or blockdiagram block or blocks.

FIG. 5 illustrates an example hardware environment for practicing atleast one embodiment of the invention. This schematic drawingillustrates a hardware configuration of an information handling/computersystem in accordance with at least one embodiment of the invention. Thesystem comprises at least one processor or central processing unit (CPU)510. The CPUs 510 are interconnected with a system bus 512 to variousdevices such as a random access memory (RAM) 514, a read-only memory(ROM) 516, and an input/output (I/O) adapter 518. The I/O adapter 518can connect to peripheral devices, such as disk units 511 and tapedrives 513, or other program storage devices that are readable by thesystem. The system can read the inventive instructions on the programstorage devices and follow these instructions to execute the methodologyof at least one embodiment of the invention. The system further includesa user interface adapter 519 that connects a keyboard 515, a mouse 517,a speaker 524, a microphone 522, and/or other user interface devicessuch as a touch screen device (not shown) to the bus 512 to gather userinput. Additionally, a communication adapter 520 connects the bus 512 toa data processing network 525, and a display adapter 521 connects thebus 512 to a display device 523, which may be embodied as an outputdevice such as a monitor, printer, or transmitter, for example.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the root terms “include”and/or “have,” when used in this specification, specify the presence ofstated features, integers, steps, operations, elements, and/orcomponents, but do not preclude the presence or addition of one or moreother features, integers, steps, operations, elements, components,and/or groups thereof.

The corresponding structures, materials, acts, and equivalents of allmeans plus function elements in the claims below are intended to includeany structure, or material, for performing the function in combinationwith other claimed elements as specifically claimed. The description ofthe present invention has been presented for purposes of illustrationand description, but is not intended to be exhaustive or limited to theinvention in the form disclosed. Many modifications and variations willbe apparent to those of ordinary skill in the art without departing fromthe scope and spirit of the invention. The embodiments were chosen anddescribed in order to best explain the principles of the invention andthe practical application, and to enable others of ordinary skill in theart to understand the invention for various embodiments with variousmodifications as are suited to the particular use contemplated.

As used above “substantially,” “generally,” and other words of degreeare relative modifiers intended to indicate permissible variation fromthe characteristic so modified. It is not intended to be limited to theabsolute value or characteristic which it modifies but rather possessingmore of the physical or functional characteristic than its opposite, andpreferably, approaching or approximating such a physical or functionalcharacteristic.

Those skilled in the art will appreciate that various adaptations andmodifications of the embodiments described above can be configuredwithout departing from the scope and spirit of the invention. Therefore,it is to be understood that, within the scope of the appended claims,the invention may be practiced other than as specifically describedherein.

1. A system for receiving an output from an external source comprising:a storage; a communications module for receiving vital-sign data from anexternal source and storing the received data in said storage; ananalysis controller in communication with said storage, said analysiscontroller monitors said storage; and a test module in communicationwith said analysis controller and said storage, said test modulereceives information from said storage through said analysis controllerand stores any output in said storage, and said test module includesrunning means for running at least one algorithm loaded into saidstorage where said at least one algorithm processes at least a portionof the information provided by said analysis controller.
 2. The systemaccording to claim 1, further comprising a ruggedized, compact housingenclosing said storage, said communications module, said analysiscontroller, and said test module.
 3. The system according to claim 2,further comprising a connector passing through a wall of said housingand in communication with said communications module.
 4. The systemaccording to claim 1, wherein said running means provides an output insubstantially real time from receipt of vital-sign data by saidcommunications module.
 5. The system according to claim 1, furthercomprising a display in communication with said test module fordisplaying at least one output produced by said test module.
 6. Thesystem according to claim 1, wherein said storage includes at least onedatabase.
 7. The system according to claim 1, wherein said storageincludes at least one database configured to store the receivedvital-sign data and at least one database configured to store the outputof said test module.
 8. A system for receiving vital-sign informationfrom a vital-sign monitor, said system comprising: a storage having atleast one database; a communications module for receiving vital-signdata from an external source and storing the received data in saiddatabase of said storage; an analysis controller in communication withsaid storage, said analysis controller monitors said storage; a testmodule in communication with said analysis controller and said storage,said test module receives information from said storage through saidanalysis controller, and said test module includes running means forrunning at least one algorithm loaded into said storage where said atleast one algorithm processes at least a portion of the informationprovided by said analysis controller, said running means provides anoutput in substantially real time from receipt of vital-sign data bysaid communications module; a ruggedized, compact housing enclosing saidstorage, said communications module, said analysis controller, and saidtest module.
 9. The system according to claim 8, further comprising aconnector passing through a wall of said housing and in communicationwith said communications module.
 10. The system according to claim 8,further comprising a display in communication with said test module fordisplaying at least one output produced by said test module.
 11. Thesystem according to claim 8, wherein said storage includes at least onedatabase configured to store the received vital-sign data and at leastone database configured to store the output of said test module.
 12. Thesystem according to claim 8, wherein said test module stores in saidstorage at least one output produced by the at least one algorithm. 13.A method for testing decision-support algorithms comprising: receivinginto storage of a ruggedized, compact computer at least onedecision-support algorithm; detecting with a communications module theinitiation of a vital-sign monitoring session; receiving and storingvital-sign information into storage by the communications module;pushing the stored vital-sign information by an analysis controller to atest module running the stored at least one decision-support algorithm;and providing at least one output from the decision-support algorithm toat least one of a database and a display.
 14. The method according toclaim 13, further comprising loading the decision-support algorithm intothe test module.
 15. The method according to claim 13, wherein themethod is performed in substantially real time.
 16. The method accordingto claim 13, wherein pushing includes retrieving the vital-signinformation from storage; and converting the vital-sign information intomultiple constant-frequency row vectors.
 17. The method according toclaim 16, wherein converting includes shifting data to leave gapsrepresenting missing data.
 18. The method according to claim 13, whereinthe storage includes capacity for storing a plurality ofdecision-support algorithms, and the storage allows for quick exchangeof stored decision-support algorithms.
 19. The method according to claim13, further comprising detecting when the vital-sign monitoring sessionterminates based on the received heart beats per minute being less than10 heart beats per minute for a predetermined time threshold, andwherein detecting the initiation of the vital-sign monitoring includesdetecting a heart beat per minute in excess of 10 heart beats perminute.
 20. The method according to claim 13, further comprisingdetermining when the vital-sign monitoring session has ended based on atleast one of a vital-sign being less than a predetermined vital-signthreshold and a signal representing an end of the vital-sign monitoringsession received from a source of the vital-sign information, andwherein detecting the initiation of the vital-sign monitoring is basedon at least one of a vital-sign being above the predetermined vital-signthreshold and a signal representing a start of the vital-sign monitoringsession received from the source of the vital-sign information